Ghana - Service Provision Assessment Survey 2002

Start	End	Cycle
2002-04	2002-09	N/A

Face-to-face [f2f]
Training and Supervision of Data Collectors

Technical advisors from the MoH and the Health Research Unit (HRU) assisted the GSS to train 54 data collectors, 48 of whom were selected. Twelve data collectors were selected to pretest the survey instruments. Three teams pretested the instruments in Greater Accra and in the eastern and central regions of the country.

All of the data collectors were nurses. Training included practical experience in completing all questionnaires in different types of health facilities, as well as role-play for the observation and exit interviews.

In total, 15 teams of three persons each participated in the data collection. Each team was composed of a team leader and two interviewers/observers. For quality control, data collection teams were supervised throughout the field activities, and for some sections of the questionnaires reinterviews were done.

Methods for Data Collection

Each team received a list of facilities to be visited. Data collection took one day in most facilities, with two days being allotted to hospitals, if required. In addition, if one of the observed services was not being offered on the day of the survey, the team returned on a day when the service was offered. If the service was offered, the clients for that day were observed. If the service was offered but no clients came (as occurred occasionally with consultations for sick children and with STI clients), the team did not revisit the facility.

The team leader was expected to ensure that the informant for each component of the facility survey was the most knowledgeable person for the particular health service or system component being addressed. Where relevant, the data collector indicated whether a specific item being assessed was observed, reported available but not observed, not available, or whether it was uncertain if the item was available. Equipment, supplies, and resources for specific services were required to be in the relevant service delivery area or in an immediately adjacent room to be accepted as available. Informed consent was taken from the facility director and all respondents for the Facility Resources Questionnaire, from observed and interviewed providers, and from clients for observations and exit interviews.

Four types of survey instruments were used for data collection:
• Facility Resources Questionnaire on resources, infrastructure and support services. The Facility Resources Questionnaire was designed to obtain information on the facilities’ preparedness to provide each of the priority services. The questionnaire was used to collect information on the availability of specific items (including their location and functional status), components of support systems (such as logistics, maintenance, and management), and facility infrastructure, including the environment in which the services are delivered. The resources assessed were those necessary to provide a level of service that meets generally accepted standards. The support services are those that are commonly acknowledged as essential management tools for maintaining health services.

• Provider interview. Providers of health services were interviewed for information on their qualifications (training, experience, continued in-service training), the supervision they had received, and their perceptions of the service delivery environment.

• Observation protocols tailored to the service being provided. Observations of consultations for sick children, antenatal care, family planning, and STIs were conducted to assess the extent to which service providers adhered to standards based on generally accepted procedures and examinations and the content of information exchanged between the provider and the client (history, symptoms, and counselling) were components of the observation.

• Exit interview with the client who was observed receiving a service. The exit interview assessed the client’s understanding of the consultation or examination as well as his or her recollection of instructions received on treatment and preventive behaviour. The ability to recall key messages increases the likelihood that a client will be able to successfully follow treatment protocols and implement preventive behaviours that optimize health outcomes. Information was also collected on the client’s perception of the service delivery environment.

These instruments were based on generic questionnaires developed in the MEASURE DHS+ project and were adapted after consulting with technical specialists from the MoH, USAID, and NGOs knowledgeable about the health services and service programme priorities covered by the GSPA survey.

Name	Abbreviation	Affiliation
Ghana Statistical Service	GSS